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June 15, 1984

Closed-Chest Massage, Kouwenhoven, Jude, Knickerbocker

Author Affiliations

From the Division of Critical Care Medicine, Department of Anesthesiology, Monefiore Hospital, University of Pittsburgh School of Medicine.

JAMA. 1984;251(23):3137-3140. doi:10.1001/jama.1984.03340470063031

Annually in the United States, approximately 1 1/2 million persons suffer a myocardial infarction.1 Of these, about 660,000 die. Approximately 60% of these deaths from acute myocardial infarction occur outside the hospital and, in the majority of cases, within the first two hours of the onset of symptoms.1 In fact, in 25% there are no premonitory signs and death is the first manifestation of coronary artery disease. The primary mechanisms of sudden death are ventricular fibrillation in 62%, ventricular tachycardia in 7%, and severe bradydysrhythmias and asystole in 31%. If there were an easily available technique that could be applied immediately after the onset of "clinical" death and rapidly followed with electrical or chemical therapy or both, it has been estimated that 200,000 to 300,000 persons could be saved annually in the United States alone.

The manuscript entitled "Closed-Chest Cardiac Massage" by W. B. Kouwenhoven, James R. Jude,